Factors that affect the variability in heart rate during endoscopic retrograde cholangiopancreatography.

Merete Christensen, Rebekka Reinert, Verner Rasmussen, Svend Schulze, Jacob Rosenberg

Journal: The European journal of surgery = Acta chirurgica 2003;168(10):546-51

PMID: 12666694

Abstract

OBJECTIVE

To find out if drugs, position, and endoscopic manipulation during endoscopic retrograde cholangiopancreatography (ERCP) influence the changes in the variability of heart rate.

DESIGN

Single-blind randomised trial.

SUBJECTS

10 volunteers given butyscopolamine, glucagon, or saline intravenously on three different study days, and 10 patients who had ERCP without butylscopolamine or glucagon.

MAIN OUTCOME MEASURES

Holter tape analysis for ischaemia and changes in the variability of heart rate.

RESULTS

5 volunteers developed tachycardia after butylscopolamine, while 2 developed tachycardia after glucagon. During ERCP 9 patients developed tachycardia, and 2 developed myocardial ischaemia. Vagal tone decreased in the volunteers after butylscopolamine, but no changes were seen after glucagon or placebo, or in patients during ERCP.

CONCLUSIONS

Butylscopolamine reduced vagal tone in volunteers. Patients who were having ERCP without butylscopolamine had a stable vagal tone. The previously observed reduced vagal tone during ERCP may therefore be primarily the result of giving butylscopolamine.

Address: Dept. of Surgical Gastroenterology, Hvidovre Hospital, Hvidovre, Denmark. [email protected]

MeSH Terms: Adult, Aged, Aged, 80 and over, Autonomic Nervous System, Butylscopolammonium Bromide, Cholangiopancreatography, Endoscopic Retrograde, Electrocardiography, Ambulatory, Female, Gastrointestinal Agents, Glucagon, Heart Rate, Humans, Male, Middle Aged, Myocardial Ischemia, Parasympatholytics, Posture, Single-Blind Method, Sodium Chloride, Tachycardia